AN INTRO TO

How Social Media &

Healthcare are Colliding

A guide that explores how social media

impacts healthcare and physicians

BRAD SMITH

Editor of the Doctor’s Journal

A Publication of

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Brad Smith is the editor of the Doctor’s

Journal, and he’s been featured in well

known media properties like the New York

Times, Business Insider, HealthWorks

Collective, and more. You can email Brad

directly at brad@doctorsjournal.com

About the Author

TABLE OF

CONTENTS

Chapter 1

How Social Media is Driving the

“Consumerization” of Healthcare

Chapter 2

Why Social Media in Healthcare is Good for

Physicians (And How You Can Adopt It)

Chapter 3

Why Social Media for Physicians has a

Positive ROI (Even If You Can’t Measure It)

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CHAPTER

1How Social Media is Driving the

Consumerization of Healthcare

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In 2004, Aaron Levie was still a college student at USC

conducting research into online storage options for his class

project.

The need to access data from different places or devices

seems obvious now. But this was pre-iPhone and iPad. And

smartphones at the time were less than good.

After a few months of prototyping, the simple storage

service was open. And the two co-founders used a novel pitch

at the time — free storage to incentivize press write-ups and

early user adoption.

And Box (formerly Box.net) was born.

To keep up with demand, Aaron and his co-founder Dylan

Smith began seeking more outside capital. Even Mark Cuban

invested $350,000. 5

But a pivotal discussion with early investor Josh Stein

encouraged Box to focus on the enterprise market. Not only

were they willing to pay more, but Stein also said they were

“stickier” which would result in a much higher LTV per

customer.

However they had an obvious problem… how was a new

upstart supposed to gain traction with the enterprise, without

a sales force and existing contacts?

Easy.

By taking advantage of how consumer behavior has

evolved.

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A traditional enterprise sales process would involve many

different people.

The technical buyers were focused on evaluating potential

vendors or suppliers. The economic buyer paid the bill. And the

user — the actual person responsible for using or adopting the

technology — was left with whatever the first two decided.

But Aaron and Dylan used the ultimate incentive — free —

which was unheard of at the time. They would adopt a “bottom

up” approach of acquiring the users first, which allowed them

to initially bypass the Technical or Economic buyers that they

didn’t have the means to reach, or cache to impress anyway.

So users began finding Box on their own, and

recommending it to their teams. Through organic and

incentivized network effects, Box has grown into a billion dollar

company — and wants to go public.

How a College Research Project

Turned into a Billion Dollar

Company

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Since then, countless other products and services have

grown in similar fashion. Early adopters are finding new

solutions and then recommending — or warning — their friends

and colleagues.

This trend isn’t just isolated to technology or software.

It’s even happening in healthcare.

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Google purchased Zagat on Sep 8, 2011. The world-

renowned rating service was founded by a husband and wife

team over 30 years ago, and grew to serve over 13 categories

in 100 countries.

The acquisition gave Google a strong local brand, and it

was immediately integrated into their Search, Maps, and

Google+ products.

And according to Rheumatologist.org, Zagat’s rating

services are expanding to provide patients a way to share

experiences of individual doctors within an insurance network:

“Wellpoint and Anthem BlueCross BlueShield members now

have the opportunity to rate their physicians in the areas of

trust, communication, availability, and office environment.”

One of the most important elements of Zagat’s new

scope is providing a total quality score that’s made up of

individual metrics for different categories. According to

Rheumatologist.org:

How Social Media is Impacting

the Consumerization of

Healthcare

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“Under the Zagat rating system, a physician who has a

high rate of medical errors but a wonderful bedside manner

and a beautiful waiting room can receive a higher rating than a

physician with a better professional record but who has trouble

communicating with his or her patients or has an outdated

waiting room.”

So the overall quality score — the one potential patients

and consumers use to decide between physicians — might be

affected more by their bedside manner than their professional

record. And it’s empowering proactive consumers to make

better decisions…without having to wait on hold or step foot

into an office.

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Seth Godin published Permission Marketing thirteen years

ago with a simple premise: the future of advertising (and

marketing) will be less about “interruption”, and more about

earning “permission”.

This seems obvious now. But before Google, Facebook

and Twitter it wasn’t.

Fast forward to 2009, and the founders behind software

company HubSpot published, Inbound Marketing: Get Found

Using Google, Social Media, and Blogs.

Different title, same premise. Capture attention, lure in

prospects, and prioritize retention and referrals.

And it’s the first step that has evolved tremendously over

the past few years. According to Forrester Research, “Eighty-

two percent of consumers researched a product before buying

it, and nearly two-thirds of respondents say they pay more

attention to prices and value now than they did a year ago”.

How to Survive & Thrive in

an Openly Connected World

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This initial point of proactive research was even given a

name by Google: The Zero Moment of Truth. And it’s

absolutely critical in today’s marketing environment.

Consumer behavior has evolved with the new connectivity

and technology at our fingertips. Digital marketing begins with

finding out how to position yourself to win consumer’s

attention and trust, in a world where everyone has access to the

same information.

Initially you reach these new consumers through organic

search when they use an informational query. Because at this

stage, they’re still “just looking”. They are recognizing their

own need awareness, and beginning to form interest.

These are affluent, educated consumers who aren’t stuck

going to whichever doctor is in their local network of plan.

They’re not looking for the best bargain.

So they’ll go to Yelp and compare reviews, ask their

friends on Facebook, and then use Zagat’s new ratings to drill

down into individual categories.

This is the same exact process my wife and I took when

we were expecting our first child and moving to a new city. We

were shopping for the best doctor, pediatrician, and hospital. In

a city filled with all of them. And with little concern for the cost.12

These customer reviews, online testimonials, and

websites were the critical first touch we had with each party —

before even meeting them or stepping foot in their offices. If

we didn’t have a good gut feeling, or there wasn’t a lot of

information available, then we simply moved on to the next

one.

The average cost of a normal birth in California was

$22,311 in 2010. No doubt that number has risen in the past

few years. And what about the second or third child?

The lifetime value of a patient or family in this case could

be over a hundred thousand dollars for every doctor and

hospital involved.

Social media and other technological advancements have

paved the way for prospective patients to shop around. Which

means marketing — the process of getting attention, building

trust, and retaining consumers or patients over the long-term

— is now a crucial part how individual practices will survive.

And it’s an essential skill for every physician to adopt.

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CHAPTER

2Why Social Media in Healthcare is Good for

Physicians (And How You Can Adopt It)

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Why Social Media in Health is

Good for Physicians (And How

You can Adopt It)

The consumerization of healthcare isn’t a passing fad,

according to PwC’s U.S. health industries leader, Kelly Barnes.

“Healthcare organizations are increasingly operating in a

world in which the voice of the consumer impacts the bottom

line, and where customer experience is now a matter of dollars

and cents.”

“As consumerism in healthcare gains steam, customer

feedback has become a determining factor in the success of

health organizations. Ratings connect consumers’ experience

to quality, and quality connects to financial performance,

market share and reputation.”

And if that doesn’t impress you, then this might:

68% of people who’ve read healthcare reviews use that

information to select their next physician, hospital, health plan,

pharmacy, and drug or medical device, according to a recent

survey from PwC’s Health Research Institute.

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The writing is on the wall. Patients can and will shop

around when they have to use more of their own money to pay

for healthcare, and there are better channels of communication

and information available to make those decisions.

Which means the way you reach them, engage them, and

retain them has to evolve as well.

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But is Social media in healthcare

Good for Physicians Too?Last year, a study in the Journal of Medical Internet

Research surveyed 485 oncologists and primary care

physicians.

60% of those physicians surveyed reported that social

media improves the quality of patient care they deliver on a

daily basis. It helps with receive new information, and engage

with colleagues or patients.

One of the authors on that paper, Brian McGowan, also

does a great job summarizing a few other key studies on his

blog, #SocialQI.

So if:

• Technology and social media are playing a big role how patients choose new

physicians

• This trend is legitimate and growing according to industry experts, and

• The majority of other physician’s surveyed rate social media as beneficial

Then… what are you waiting for? There are a few common

reasons (or excuses). And some are very real.

Take patient confidentiality for starters. A recent research

paper from the American College of Physicians and the

Federation of State Medical Boards identifies a few major points

in regards to physicians using online media technology:

1. Be mindful of ethical principles in regards to confidentiality, privacy, respect

2. Try to keep professional and personal social spheres separate

3. Document patient communication and stick to email (when there’s consent)

4. “Self-audit” your own online presence to make sure the information is factual

and accurate

5. Be aware that these online postings will be around a long time (and could have

future implications)

All of these points are important to keep in mind. But

they’re also pretty straight-forward and obvious.

Which could mean a lot of physicians hold back on using

social media because they’re not sure where to get started,

they don’t have a mental framework for how it fits in their life,

and they don’t understand the impact it has.

So here are three simple questions you can work through

below, that will help you adopt new online media technologies

into your daily routine and practices.

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Question #1.

Why Would You Use It?

Most lackluster social media results can be directly

attributable to a disconnect between the (a) purpose and (b)

execution.

If you can’t define success before you begin, then it will

never make a positive dent in your daily routine (no matter how

many times you update a Facebook page or send out a Tweet).

This simple decision affects everything else. For example,

what platform should you choose to focus on? (Because in most

cases, you can’t excel at all of them.)

So do you want to…

• Stay informed and on top of the latest news? → Twitter

• Keep up with colleagues, associates and opportunities? → LinkedIn

• Engage with patients and provide support? → Facebook

• Increase your organization’s “reach” and “awareness”? → Yelp

Start here, and then you’ll have a framework for guiding

the next few decisions.

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Question #2.

How Are You Going To

manage it?

Now that you know why, let’s talk about how. What’s

your role in the process?

Are you going to be a hands-on patient advocate, or

would you rather outsource and let someone else worry about

it?

Doesn’t matter which one you choose — you just need to

prepare accordingly.

If you want to be heavily involved, then pick up some

“time hacks” to speed up your social media productivity.

And if you want someone else to manage it, then what’s

the relationship (e.g. a resident, independent vendor, etc.), and

what are the checks and balances?

A simple policy might help, but you’ll also need to think

about your purpose (#1), and what are the concrete steps that

will get you closer to achieving it.

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Question #3.

What’s the Feedback Loop?

If you (a) know the purpose behind an activity, and (b) can

see who’s responsible, then you’ll know exactly how to

measure the performance over time.

And you’ll be able to see how it contributes to your

thought leadership, patient care, or the bottom line.

If your goal is thought leadership, then identify some

simple actionable metrics, like articles published, interviews

given, and colleagues contacted.

If you want to improve patient care, then how easily can

they reach you, how often do you respond, which channels

should you have a presence (like Yelp), and how many reviews

per month can you incentivize?

And if you want to improve your bottom line, then you

can even use an old copywriting framework — AIDA — which

stands for:

• Attention

• Interest

• Desire (or trust)

• Action

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Now plot a few simple metrics like so:

And link your activities to each of these stages, which will

help you rationalize (or justify) the time, money and energy it

takes.

But take caution with this approach, because unrealistic

expectations can also be damaging to your progress.

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A Caveat

Social media hasn’t changed communication or

marketing — it’s just changed the delivery and distribution.

So if you want social media to build your practice and

improve your bottom line, then like most brand-building

marketing activities, you can’t sell directly with it (at least, not

all the time). It’s hard to pinpoint a direct ROI like there is with

direct mail or Google AdWords.

And correlation doesn’t always equal causation. So…

how are you supposed to use social media to improve the

bottom line?

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CHAPTER

3Why Social Media for Physicians has a

Positive ROI (Even If You Can’t Measure It)

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Forrester Research analyzed over 77,000 consumer

orders in 2012 to figure out which online marketing channels

buyers (not just traffic) were coming from.

And they found that despite recent changes in technology

trends over the past few years, buyers tend to be influenced in

largely the same ways.

Specifically, their research showed:

• SEO and Paid Search are best for new customers.

• Email is best for repeat customers.

• And social tactics are meaningless sales drivers — accounting for less than 1% of

sales

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One of the biggest problems is that social media’s

influence is hard to track. That’s why it’s nearly impossible to

show a direct influence on sales without complex, sophisticated

attribution models (that still don’t do the trick very effectively).

But then again, it’s also difficult to show the ROI for

television ads, billboards, radio spots, putting your brand name

in a stadium, and most other forms of brand advertising or

marketing.

Yet they work. They correlate to improved sales (even

though that doesn’t prove causation). And brand still spend

millions on them each year.

Social media hasn’t changed marketing. So it can’t be

judged in isolation.

It’s just added some new distribution and delivery

options for those organization’s brave enough to forge ahead,

and creative enough to actually make it work.

And this is true regardless of what industry — because

social media is consumerizing healthcare. So these same rules

now apply to physicians and practices too.

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Why a Toy Maker Can Teach

You About How to use Social

Media for Physicians

“Social media” goes beyond updating your Facebook

page or throwing a Facebook button on your website.

And leading toy maker Step2 is proof of that. For

example, they’ve used the Facebook Connect feature to create

PowerReviews — a mini Amazon-like experience for their

consumers. To date, 20,000 peer-to-peer reviews have been

left.

Tena Crock, the Online Marketing Director for Step2 told

the Wall Street Journal:

“Sales from Step2.com increased 130 percent year-over-

year after PowerReviews added loyalty and badges for

reviewers and buyers in February 2012. Since October 2010,

Step2 has recorded a 300% boost in revenues from visitors who

arrive at Step2.com via the Facebook Connect button.”

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So social media can be used effectively to generate

sales… even if it’s indirect. Because it does two

important things for your brand:

• Allows you to reach more people, with less cost (decreasing the cost

of customer acquisition)

• Keeps people engaged longer (increasing the lifetime value of a

customer)

• Each business — no matter what industry, vertical or profession — has

a cost to acquire each customer. That could be hard costs like direct

mail, or soft costs like salaries for marketing and sales people.

And the lifetime value of a customer is more

important now than ever. Global competition’s at an all-

time high, and technology continues to disrupt they way

every single industry operates.

Social media improves your marketing ROI

because it decreases the cost of acquiring new

customers, while increasing the lifetime value of that

customer at the same time.

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How a Software Company Grew

Revenues from Less than $1

Million to $20 Million in Only 5

Years

On May 1st, 2012, online marketing software company

SEOmoz announced that they raised $18 million dollars.

In an incredibly transparent blog post, they even shared

the pitch deck with key business metrics that detailed their

journey reaching this point.

SEOmoz was originally an SEO consulting company,

before releasing a suite of tools in 2007 and pursuing products

full time. Since then, they’ve grown revenues from under a

million to about $20 million in five years.

One of the reasons they were able to grow so quickly was

their huge, active audience in place. Their website gets 2

million visits per month, they have over 200,000 email

subscribers, and over 100,000 Twitter followers and RSS

subscribers. Having a huge audience like this means that they

acquired almost all of their customers (85%) organically —

through these “inbound” or social strategies.

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So the cost to acquire each customer was only around

$78. (Whereas if they used traditional “outbound” sales or paid

acquisition — the same ways that most other companies grow

quickly — the cost of customer acquisition would have been 2-

3x more!)

But lowering the costs of acquisition isn’t all. These

strategies also increase the lifetime value of each customer. For

SEOmoz, that means each customer is worth over $1,000.

Now compared to the tiny amount of $78 to acquire, and

you can see that these strategies not only impact sales, but can

also be highly profitable.

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3 Ways Social Media Can Bring in

More Patients & Keep Them

Around Longer

Most organizations have lackluster social media results

because of lackluster execution.

Usually this stems from a misunderstanding of how to

adopt these new technologies into day-to-day routines or

processes.

But once you can move past the readiness (and

willingness) of adoption in your organization, there are three

primary ways to improve an organization’s goals with social

media:

Step #1.

Increase Sales through

Increasing Conversions

When you combine social media with other online

marketing channels like organic search or email marketing, it

enables you to develop engagement faster.

What’s so important about engagement?

Engagement builds that “missing link” between strangers

and loyal patients. Namely, trust.

People need to know, like and trust you before they buy.

Or listen to your recommendations. Or decide to come back. Or

tell their friends to give you a try.

But social media can help bridge this gap, and indirectly

drive more conversions. All while costing you less out-of-pocket

when you compare it to the traditional marketing techniques

you would have to use for similar results.

One of the best ways to quickly drive engagement is

through a social media promotion. They can help you break up

the day-to-day monotony, and provide an incentive to interact

and share.

Here are a few quick tips for running a successful online

promotion:

1. Determine Your Goal: If your goal is to increase engagement, then create an

interactive contest where people need to get involved and contribute somehow.

2. Partner with Others: Who are the groups, people, or brands that influence your

potential patients? Find those people, and partner with them. You could give

away their products to your audience (to keep the cost down), or you can cross-

promote your contest to their audience to grow your own reach as well.

3. Include Bloggers: Bloggers are much easier to work with than traditional

journalists, and they can give you the same end results — more eyeballs. Think

about how you can get them involved, so they will help promote your new

contest.

4. Add a Viral Hook: Finally, you always want to include a viral hook where you

can. For example, Wildfire enables you to give contests an extra incentive to

promote the contest for you. The winners (or finalists) of the contest will be the

ones with the most social media votes.

Promotions like this can give you a quick shot of

engagement, while also exposing your brand and practice to

new audiences.

Which brings us to the next benefit…

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Step #2.

Decrease Costs through

Increasing Awareness (for Less)

The built-in network effects of social media helps

messages travel faster and further for cheaper than other

alternatives (like television ads, billboards, or print).

And you can also reach customers sooner in the buying

cycle.

Most potential patients can now read all about you at the

“zero moment of truth” on review services like Yelp, and

through Google+.

Where is the first place you go to do research online?

Google. And everyone’s search results are now personalized

based on (1) your past browsing history, (2) your physical

location, and (3) your social media connections.

Yelp and Google+’s local and business information will

give these people a quick snapshot of an entire area in just a

few minutes — before having to call anyone or visit your

website.

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Your Google Place (and Maps) information is now

integrated with Google+. So improving your Google+ presence

will go a long way to improving your local search results.

So where should you start?

Incentivize Google+ reviews. Not in a shady, unethical

way. But get creative. What local businesses can you partner

with to offer discounts your patients if they leave a review after

their visit?

You can also combine this with lifecycle email marketing

campaigns to automatically remind and follow-up with everyone

that leaves your office.

Simply schedule a few emails to go out 3, 7, and 21 days

after each patient’s visit. And you should immediately start to

see a notable increase in reviews.

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Step #3.

Increase Customer Support

through Increasing Customer

Loyalty

Finally, improving customer loyalty is key to increasing

the lifetime value of each patient.

And there’s no better channel than social media, because

of the availability (24/7), scale, and potential for personalized

one-on-one attention.

For example, regular content creation and syndication will

increase your thought leadership and brand positioning as the

go-to expert for your niche in your area. This drives more

demand and “lead generation” — or new people walking in

your door.

Start with the common questions you get, or recurring

“pain points” that keep coming up.

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And don’t just stop at the symptoms. Dive deeper into

outcomes or affect it has on people’s day-to-day lives.

Sympathize with their condition, present the problems

associated with it, and then offer up the solution (you — and

your services).

This will help build a platform and community of people,

which creates stronger ties between patients and your practice.

And it enables you to generate more new referrals

(without necessarily doing a lot more work to solicit them).

Which is critical, because referrals are the easiest and

best source of new business. They automatically trust you, and

are predisposed to like you.

True word-of-mouth is rare, but powerful. And social

media is the best way to harness it online.

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About The Doctor’s Journal

Economies are undergoing unprecedented change,

healthcare is becoming “consumerized”, and careers

are becoming more entrepreneurial.

The Doctor’s Journal chronicles this journey, and keeps

you ahead of the curve with weekly in-depth articles on

business, technology marketing, and finance.

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Please share it with your friends and colleagues to help

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